Skip to main content
SpringerLink
Log in

Disorders of the Neck and Back

Family Medicine

  • 64 Accesses

Abstract

Low back pain (LBP) is a heterogeneous condition with high prevalence, high morbidity, and large economic burden. According to the 2010 Global Burden of Disease Study, low back pain ranked highest among 291 studied disorders in terms of years lived with disability (YLDs), with a global point prevalence estimated to be 9.4% (95% CI 9.0–9.8). In 2005, direct expenditures for spine problems in the United States were estimated at $85.9 billion, which represented 9% of the total national healthcare expenditures, similar to costs associated with arthritis, cancer, and diabetes, and only exceeded significantly by those for heart disease and stroke. In the United States between 2004 and 2008, it is estimated that over two million episodes of back pain resulting in presentation for emergency care occurred, yielding an incidence rate of 1.39/1000 person-years. In workers 40–65 years of age, back pain costs employers an estimated $7.4 billion/year in lost productive time. Commonly, disorders of the neck and back are self-limiting conditions, which require only judicial use of imaging and rarely more invasive treatments. Many national and international groups have produced high-quality, evidence-based recommendations to aid in the diagnosis and treatment of low back pain.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(6):968–74.

    Article  PubMed  Google Scholar 

  2. Martin BI, Deyo RA, Mirza SK, Turner JA, Comstock BA, Hollingworth W, Sullivan SD. Expenditures and health status among adults with back and neck problems. JAMA. 2008;299(6):656–64.

    Article  CAS  PubMed  Google Scholar 

  3. Waterman BR, Belmont PJ, Schoenfeld AJ. Low back pain in the United States: incidence and risk factors for presentation in the emergency setting. Spine J. 2012;12(1):63–70.

    Article  PubMed  Google Scholar 

  4. Ricci JA, Stewart WF, Chee E, Leotta C, Foley K, Hochberg MC. Back pain exacerbations and lost productive time costs in United States workers. Spine (Phila Pa 1976). 2006;31(26):3052–60.

    Article  Google Scholar 

  5. Chou R, Qaseem A, Snow V, Casey D, Cross JT, Shekelle P, Owens DK. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478–91.

    Article  PubMed  Google Scholar 

  6. Deyo RA, Mirza SK, Martin BI. Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002. Spine (Phila Pa 1976). 2006;31(23):2724–7.

    Article  Google Scholar 

  7. Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24(6):769–81.

    Article  CAS  PubMed  Google Scholar 

  8. Cohen SP, Argoff CE, Carragee EJ. Management of low back pain. BMJ. 2008;337:a2718.

    Article  PubMed  Google Scholar 

  9. Henschke N, Maher CG, Refshauge KM, Herbert RD, Cumming RG, Bleasel J, et al. Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study. BMJ. 2008;337:a171.

    Article  PubMed  Google Scholar 

  10. Turner JA, Franklin G, Fulton-Kehoe D, Sheppard L, Stover B, Wu R, et al. ISSLS prize winner: early predictors of chronic work disability: a prospective, population-based study of workers with back injuries. Spine (Phila Pa 1976). 2008;33(25):2809–18.

    Article  Google Scholar 

  11. Stanton TR, Henschke N, Maher CG, Refshauge KM, Latimer J, McAuley JH. After an episode of acute low back pain, recurrence is unpredictable and not as common as previously thought. Spine (Phila Pa 1976). 2008;33(26):2923–8.

    Article  Google Scholar 

  12. Patrick N, Emanski E, Knaub MA. Acute and chronic low back pain. Med Clin North Am. 2014;98(4):777–89, xii

    Article  PubMed  Google Scholar 

  13. Raison NTJ, Alwan W, Abbot A, Farook M, Khaleel A. The reliability of red flags in spinal cord compression. Arch Trauma Res. 2014;3(1):e17850.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Downie A, Williams CM, Henschke N, Hancock MJ, Ostelo RWJG, de Vet HCW, et al. Red flags to screen for malignancy and fracture in patients with low back pain: systematic review. BMJ. 2013;347:f7095.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Suri P, Rainville J, Katz JN, Jouve C, Hartigan C, Limke J, et al. The accuracy of the physical examination for the diagnosis of midlumbar and low lumbar nerve root impingement. Spine (Phila Pa 1976). 2011;36(1):63–73.

    Article  Google Scholar 

  16. Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. Chapter 4: European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl 2):S192–300.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Deyo RA, Jarvik JG, Chou R. Low back pain in primary care. BMJ. 2014;349:g4266.

    Article  PubMed  Google Scholar 

  18. Chou R, Fu R, Carrino JA, Deyo RA. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet. 2009;373(9662):463–72.

    Article  PubMed  Google Scholar 

  19. Savigny P, Watson P, Underwood M. Guideline development group. Early management of persistent non-specific low back pain: summary of NICE guidance. BMJ. 2009;338:b1805.

    Article  PubMed  Google Scholar 

  20. Beattie PF, Meyers SP, Stratford P, Millard RW, Hollenberg GM. Associations between patient report of symptoms and anatomic impairment visible on lumbar magnetic resonance imaging. Spine (Phila Pa 1976). 2000;25(7):819–28.

    Article  CAS  Google Scholar 

  21. Goode AP, Carey TS, Jordan JM. Low back pain and lumbar spine osteoarthritis: how are they related? Curr Rheumatol Rep. 2013;15(2):305.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Roh JS, Teng AL, Yoo JU, Davis J, Furey C, Bohlman HH. Degenerative disorders of the lumbar and cervical spine. Orthop Clin N Am. 2005;36(3):255–62.

    Article  Google Scholar 

  23. Jegede KA, Ndu A, Grauer JN. Contemporary management of symptomatic lumbar disc herniations. Orthop Clin North Am. 2010;41(2):217–24.

    Article  PubMed  Google Scholar 

  24. Kreiner DS, Shaffer WO, Baisden JL, Gilbert TJ, Summers JT, Toton JF, et al. An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis (update). Spine J. 2013;13(7):734–43.

    Article  PubMed  Google Scholar 

  25. Sweet MG, Sweet JM, Jeremiah MP, Galazka SS. Diagnosis and treatment of osteoporosis. Am Fam Physician. 2009;79(3):193–200.

    PubMed  Google Scholar 

  26. Sciubba DM, Gokaslan ZL. Diagnosis and management of metastatic spine disease. Surg Oncol. 2006;15(3):141–51.

    Article  PubMed  Google Scholar 

  27. Sundaresan N, Boriani S, Rothman A, Holtzman R. Tumors of the osseous spine. J Neuro-Oncol. 2004;69(1–3):273–90.

    Article  Google Scholar 

  28. Varlotta GP, Lefkowitz TR, Schweitzer M, Errico TJ, Spivak J, Bendo JA, Rybak L. The lumbar facet joint: a review of current knowledge: part II: diagnosis and management. Skelet Radiol. 2011;40(2):149–57.

    Article  Google Scholar 

  29. Sengupta R, Stone MA. The assessment of ankylosing spondylitis in clinical practice. Nat Clin Pract Rheumatol. 2007;3(9):496–503.

    Article  CAS  PubMed  Google Scholar 

  30. Klineberg E, Mazanec D, Orr D, Demicco R, Bell G, McLain R. Masquerade: medical causes of back pain. Cleve Clin J Med. 2007;74(12):905–13.

    Article  PubMed  Google Scholar 

  31. Hill JC, Whitehurst DG, Lewis M, Bryan S, Dunn KM, Foster NE, et al. Comparison of stratified primary care management for low back pain with current best practice (start back): a randomised controlled trial. Lancet. 2011;378(9802):1560–71.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Foster NE, Mullis R, Hill JC, Lewis M, Whitehurst DGT, Doyle C, et al. Effect of stratified care for low back pain in family practice (impact back): a prospective population-based sequential comparison. Ann Fam Med. 2014;12(2):102–11.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Cherkin D, Balderson B, Wellman R, Hsu C, Sherman KJ, Evers SC, et al. Effect of low Back pain risk-stratification strategy on patient outcomes and care processes: the MATCH randomized trial in primary care. J Gen Intern Med 2018; 33(8):1324–1336. https://doi.org/10.1007/s11606-018-4468-9. Epub 2018 May 22.

  34. Chou R. Pharmacological management of low back pain. Drugs. 2010;70(4):387–402.

    Article  CAS  PubMed  Google Scholar 

  35. Chou R, Fanciullo GJ, Fine PG, Adler JA, Ballantyne JC, Davies P, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Chou R, Huffman LH. Medications for acute and chronic low back pain: a review of the evidence for an American pain society/American college of physicians clinical practice guideline. Ann Intern Med. 2007;147(7):505–14.

    Article  PubMed  Google Scholar 

  37. Guild DG. Mechanical therapy for low back pain. Prim Care. 2012;39(3):511–6.

    Article  PubMed  Google Scholar 

  38. Hayden JA, Van Tulder MW, Malmivaara AV, Koes BW. Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med. 2005;142(9):765–75.

    Article  PubMed  Google Scholar 

  39. Poquet N, Lin CW, Heymans MW, van Tulder MW, Esmail R, Koes BW, Maher CG. Back schools for acute and subacute non-specific low-back pain. Cochrane Database Syst Rev. 2016;4:CD008325.

    PubMed  Google Scholar 

  40. Vibe Fersum K, O’Sullivan P, Skouen JS, et al. Efficacy of classification-based cognitive functional therapy in patients with non specific chronic low back pain: a randomized trial. Eur J Pain. 2013;17(6):916–28.

    Article  CAS  PubMed  Google Scholar 

  41. Assendelft WJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG. Spinal manipulative therapy for low back pain. Cochrane Database Syst Rev. 2004;1(1):CD000447.

    Google Scholar 

  42. Furlan AD, van Tulder M, Cherkin D, Tsukayama H, Lao L, Koes B, Berman B. Acupuncture and dry-needling for low back pain: an updated systematic review within the framework of the cochrane collaboration. Spine (Phila Pa 1976). 2005;30(8):944–63.

    Article  Google Scholar 

  43. Chou R, Hashimoto R, Friedly J, et al. Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis: a systematic review and meta-analysis. Ann Intern Med. 2015;163:373–81. https://doi.org/10.7326/M15-0934.

    Article  PubMed  Google Scholar 

  44. Atlas SJ, Keller RB, Wu YA, Deyo RA, Singer DE. Long-term outcomes of surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: 10 year results from the Maine lumbar spine study. Spine (Phila Pa 1976). 2005;30(8):927–35.

    Article  Google Scholar 

  45. Chou R, Shekelle P. Will this patient develop persistent disabling low back pain? JAMA. 2010;303(13):1295–302.

    Article  CAS  PubMed  Google Scholar 

  46. Eubanks JD. Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms. Am Fam Physician. 2010;81(1):33–40.

    PubMed  Google Scholar 

  47. Bono CM, Ghiselli G, Gilbert TJ, Kreiner DS, Reitman C, Summers JT, et al. An evidence-based clinical guideline for the diagnosis and treatment of cervical radiculopathy from degenerative disorders. Spine J. 2011;11(1):64–72.

    Article  PubMed  Google Scholar 

  48. Peeters GG, Verhagen AP, de Bie RA, Oostendorp RA. The efficacy of conservative treatment in patients with whiplash injury: a systematic review of clinical trials. Spine (Phila Pa 1976). 2001;26(4):E64–73.

    Article  CAS  Google Scholar 

  49. Côté P, Cassidy JD, Carroll L, Frank JW, Bombardier C. A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine (Phila Pa 1976). 2001;26(19):E445–58.

    Article  Google Scholar 

  50. Toledano M, Bartleson JD. Cervical spondylotic myelopathy. Neurol Clin. 2013;31(1):287–305.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Family Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA

    James Winger

Authors
  1. James Winger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James Winger .

Editor information

Editors and Affiliations

  1. Department of Family Medicine, University of Nebraska, Omaha, NE, USA

    Paul Paulman

  2. Department of Family and Community Medicine, Eastern Virginia Medical School, Norfolk, VA, USA

    Robert B. Taylor

  3. Department of Family Medicine, University of Nebraska Medical Center, Omaha, NE, USA

    Audrey A. Paulman

  4. Department of Family Medicine, Creighton University, Omaha, NE, USA

    Laeth S. Nasir

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer International Publisher Switzerland

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Winger, J. (2020). Disorders of the Neck and Back. In: Paulman, P., Taylor, R., Paulman, A., Nasir, L. (eds) Family Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0779-3_116-2

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-0779-3_116-2

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-0779-3

  • Online ISBN: 978-1-4939-0779-3

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Chapter history

  1. Latest

    Disorders of the Neck and Back
    Published:
    26 May 2020

    DOI: https://doi.org/10.1007/978-1-4939-0779-3_116-2

  2. Original

    Disorders of the Neck and Back
    Published:
    16 February 2015

    DOI: https://doi.org/10.1007/978-1-4939-0779-3_116-1

Search

Navigation